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Prognostic value of the ankle-brachial index in elderly patients with a stable chronic cardiovascular event

L Manzano1, J M Mostaza, C Suarez

  • 1Heart Failure and Vascular Risk Unit, Internal Medicine Department, Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain. luis.manzano@uah.es

Journal of Thrombosis and Haemostasis : JTH
|March 17, 2010
PubMed

Insights

Undiagnosed peripheral arterial disease (PAD) significantly increases cardiovascular event risk in elderly patients with existing heart or cerebrovascular conditions. Early PAD detection via ankle-brachial index (ABI) identifies high-risk individuals needing intensified treatment.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Geriatric Medicine

Background:

  • Polyvascular arterial disease patients face higher atherothrombotic event risks.
  • Stable coronary or cerebrovascular disease patients may have undiagnosed peripheral arterial disease (PAD).

Purpose of the Study:

  • To assess the prognostic value of detecting undiagnosed PAD using the ankle-brachial index (ABI).
  • To evaluate ABI's predictive capability in elderly patients with stable cardiac or cerebrovascular disease.

Main Methods:

  • A multicenter, prospective cohort study.
  • Inclusion of 1096 elderly patients (65-85 years) with prior atherothrombotic events but no established PAD.
  • Follow-up duration of 11.7 months.

Main Results:

  • Ankle-brachial index (ABI) < 0.9 found in 29.9%; ABI > 1.4 in 6.9%.
  • ABI < 0.9 strongly predicted combined cardiovascular death and non-fatal events (HR 1.99).
  • ABI > 1.4 correlated with increased total and cardiovascular mortality.

Conclusions:

  • Undiagnosed PAD, detected by ABI, identifies a high-risk population in stable cardiovascular disease patients.
  • These findings suggest potential benefits from more intensive management strategies for identified high-risk individuals.
Abstract

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